NPI | 1588601538 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208C00000X Colon & Rectal Surgery (Licence: PA MD069212L) |
Additional Taxonomies | 208600000X Surgery (Licence: PA MD069212L) |
Enumeration Date | 2006-05-31 |
Last Update Date | 2016-08-30 |